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Statins: What you need to know

Published: 11/18/2013

The American Heart Association and the American College of Cardiology announced new guidelines about cholesterol-lowering statin drugs. Einstein cardiologist Christian Witzke, MD, explains what the new guidelines may mean for patients.

It’s estimated that as many as a quarter of Americans age 45 and older already take statins such as atorvastatin (Lipitor), simvastatin (Zocor), rosuvastatin (Crestor), and others to treat high cholesterol. All of the statins except for Crestor, are available in generic versions. Many more people could be prescribed statins under the new recommendations, which represents a dramatic change in the way doctors evaluate and treat cardiovascular risk.

Statins are drugs that lower cholesterol by blocking a substance in the body that’s needed to make cholesterol. Statins may also help your body reabsorb cholesterol that has built up in plaque on the artery walls, preventing further blockage in the blood vessels and heart attacks.

A new formula has been developed to help doctors calculate a person’s risk of a heart attack or stroke, particularly for people in certain risk categories. This represents a major change from the approach currently used which focuses on the level of a patient’s low-density lipoproteins (LDL) – the “bad cholesterol.” With the new guidelines, doctors will consider other factors such as the person’s age, weight, blood pressure, whether they smoke or have diabetes. If a person has even a moderate risk of a heart attack or stroke, he or she should be prescribed statins, regardless of their LDL score.

The new guidelines recommend prescribing statins for people in high-risk groups, including: people who have previously had a heart attack, stroke, or cardiovascular disease; people with an LDL of 190 or higher; people with diabetes; and anyone over 40 with a 7.5 percent risk of a heart attack in the next 10 years.

For people who are not in these risk groups but may have an elevated cholesterol level, the committee that developed the new recommendations say that lifestyle and behavior management should be sufficient to manage high cholesterol. Lifestyle improvements include quitting smoking, eating a healthy diet that’s low in fat, cholesterol and salt, and exercising 30 minutes a day, 3 to 4 days a week.

It’s always a good idea to speak with a medical professional if you have questions or concerns about lowering your risk of heart disease, the new guidelines, or the role of statins.